To Tell or not to tell

[boid_86]

Hi my name is Nathan and I've got a moral reasoning report this wedsday..I need your help guys as the case is confusing for me.Here's the narrative case:

Mrs Resevski has been admitted for falls & generalised weakness for investigation. She is 85, widowed, lives alone, but has 6 sons and daughters, grandchildren and great grandchildren, many of whom visit her regularly. She undergoes several tests and one of those is an abdominal ultrasound, the results of which show that she has a very large abdominal tumour.

This finding is documented in her notes, but you are informed at handover that Mrs Resevski herself does not yet know, as her son has requested staff that she not be told until an oncologist can come to see her. Later that shift, Mrs Resevski asks you if her scan results are back yet and if so what they are.

Assess the key ethical decision(s) that were/could/should and/or need to be made in this situation and the moral reasoning for them.

[loriangel14, RN]

That's pretty simple. Test results, especially serious ones are always disclosed by the doctor. Revealing and discussing test results and treatment options are the responsibility of the doctor, not nursing staff. I would fully expect that in this situation it would be a given that nursing staff would not tell the patient about her abdominal tumor.If the patient asks about her test results you would tell her that they are back and that the doctor will be discussing the results with her. You are not lying to the patient about the results being back but you are letting her know that you are not the one that she will be discussing the results with.

[Fiona59]

Aw, lori, quit doing the young 'uns homework!

[boid_86]

Thanks Lori,actually I've had some disagreements with my collegues at work that's why I also want to know other people's opinion about this..to be honest I'm not good at these kinds of situations.

[loriangel14, RN]

Aw, lori, quit doing the young 'uns homework!

Aww you caught me! I should know better.:)

[loriangel14, RN]

Thanks Lori,actually I've had some disagreements with my collegues at work that's why I also want to know other people's opinion about this..to be honest I'm not good at these kinds of situations.

That situaton isn't really about morals or ethics but more about scope of practice and your role.

[boid_86]

I thought it is within the nurse's scope to tell the patient her result. I was told before that nurses are allowed to tell test results except interpreting them as it is the physician's responsibility.

[loriangel14, RN]

I have on occassion explained to a patient that she is starting an antibiotic because she has a UTI, but telling a patient she has an abdominal tumor is not news a nurse would be delivering.